Our brains are constantly processing thousands of different stimuli at once. There’s the noise of traffic outside. A video ad is playing on a nearby screen. You pass by a coworker who is wearing heavy perfume. It’s cold outside, and the heaters are blasting out warm air. All of these things could be happening at once, and our brain is typically able to handle them and reassure us that it’s nothing to worry about.
But sometimes, it can be too much. Maybe you could deal with your coworker’s excessive perfume on its own. But when it’s combined with the heaters and fluorescent overhead lights, it begins to feel overwhelming and you lose focus on your work and pay more attention to your surroundings. When your senses—sight, touch, smell, taste, and hearing—come flooding in to the point where you don’t feel as if you can handle it anymore, it can be indicative of a sensory processing challenge.
Anyone can have sensory issues, but for someone with obsessive compulsive disorder (OCD), struggles with sensory processing can cause additional anxiety. You may obsess over the sensation you’re trying to process, such as being in a loud environment. As a result, you perform compulsions to block it out or find relief from the anxiety it brings.
OCD is frequently a comorbid condition, meaning that it occurs alongside other mental health issues. OCD is typically associated with anxiety and depression, but it can also latch on to or exist with sensory processing conditions.
Before we learn how each affects the other, let’s make sure we have a solid understanding of what OCD is and what sensory processing actually means.
Understanding sensory processing
Sensory processing is how our brain takes in and organizes information from the world around us, through sound, touch, sight, smell, taste, as well as through other more complex sensory systems in our bodies. You can think of it as a conductor managing a complex orchestra, where each sense plays its part. When everything is working smoothly, it helps us navigate daily life. But when sensory processing is off, it can feel overwhelming or cause discomfort with specific sensations, leading to challenges like sensory overload or difficulty handling certain environments.
In terms of OCD sensory issues, there are a couple of definitions that are helpful to know:
- Sensory sensitivity means being more reactive to everyday sensations like sounds, textures, or lights. Noises that others might ignore can be unbearably loud, certain fabrics might feel uncomfortable on the skin, or bright lights can cause discomfort, like headaches or feeling hot. These sensitivities can make daily life more challenging, but they’re not uncommon.
- Sensory overload is when all of the different sensory tasks our brain has to process become too much to handle and get extremely overwhelming. It is a type of sensory processing issue that can make us feel like shutting down due to overstimulation. Sensory overload can manifest itself in many different ways, including headaches, irritability, nausea, social withdrawal, anxiety, emotional outbursts, shutdowns, and more.
OCD and sensory issues
If you have obsessive compulsive disorder, you experience unwanted and persistent intrusive thoughts, images, urges, sensations, and feelings that cause intense anxiety, fear, and discomfort. In order to find relief or to prevent your fears from coming true, you may engage in physical or mental actions behaviors known as compulsions. These repetitive behaviors are meant to get rid of the intrusive thoughts, but since they only provide temporary relief, you can get stuck in a cycle of having obsessions and performing compulsions.
Intrusive thoughts can be confusing. If you don’t have OCD, you probably won’t think that seeing the color red more than usual means you’re going to die soon. Hearing a slight hum due to construction outside won’t make you think that you’re going deaf. Right? But if you do have OCD, these thoughts feel very real, even though you can acknowledge that they are outlandish. And so performing a compulsion—like thought blocking, avoidance, repeating a phrase, or seeking constant reassurance—feels absolutely necessary.
April Kilduff, MA, LCPC, LMHC, and Clinical Trainer at NOCD, explains, “Anything intrusive by definition will be triggering and stimulating in a negative way. As people with OCD get closer to what we’re describing as sensory overload or overstimulation, that’s when the urge to do compulsions is the strongest.”
As people with OCD get closer to what we’re describing as sensory overload or overstimulation, that’s when the urge to do compulsions is the strongest.
It is important to note that sensory processing issues are common in both OCD and autism. OCD can occur with autism, but it can also mask signs of autism (and vice versa) because of the similarities between stimming and performing compulsions. Sensory processing can serve as diagnostic criteria for autism—Autistic people may have heightened sensitivities to triggers such as sounds, textures, or lights, which can sometimes be mistaken for OCD-related compulsions. In fact, research shows that people with autism are twice as likely as those without it to be diagnosed with OCD later in life. Similarly, people with OCD are four times more likely to be diagnosed with autism. If you think you might have OCD as well as autism, it is important to speak with your healthcare provider to get a formal diagnosis so you can get the right care.
Do people with OCD have sensory issues?
Research shows that people who live with OCD can be more sensitive to sensory stimuli than others, making it harder to ignore things that most other people don’t find bothersome. White noise, for example. This doesn’t mean that OCD and sensory processing disorder always go hand in hand; some people with OCD might not experience any sensory issues, while for others, it can be the root cause of their intrusive thoughts and feelings. Conversely, not everyone that has sensory processing dysfunctions has OCD. The two certainly can affect and play off each other, but it depends on the individual person and their experiences.
For example, say someone cannot stop focusing on the bright lights in a room. They’ve asked the people around them if they think the lights are too bright and everyone said no. Now, the person is focusing on why they think the lights are too bright when no one else does. They keep staring at the lights to prove to themselves that they don’t actually have a problem with them, which causes headaches and dizziness. Meanwhile, a different person might find the bright lights a bit over stimulating without feeling the need to react. The lights might give them headaches, but they don’t feel obsessed with them or have the urge to perform a compulsion.
Is sensory OCD real?
Sensory processing issues can play a major role in intrusive thoughts and obsessions because of the distress and shift in focus they bring. However, there is a specific subtype of sensory OCD called somatic OCD (also known as sensorimotor OCD) that is more closely related to sensory issues than other subtypes.
Somatic OCD fixates on autonomic bodily processes and functions, such as breathing, blinking, swallowing, heartbeat/heart rate, eye contact, chewing, the movement/feeling of one’s tongue, bladder or bowel pressure, itching, or even the internal mechanism of thinking.
Dr. Patrick McGrath, Chief Clinical Officer at NOCD, says the core fear for someone with somatic OCD tends to be, “What if my body is not doing something the right way?” The person feels the need to take control of the function they’re fixated on. This hyper attentiveness and need for control can cause a problem where there isn’t one, as the more we focus on something, the more likely we are to find something “wrong” with it.
People with somatic OCD experience obsessions—which can manifest as intrusive thoughts, sensations, images, feelings, or urges—surrounding one or more bodily functions. Because autonomic processes are, by definition, happening all the time, people who have this OCD subtype likely find themselves constantly triggered. In order to relieve themselves of the distress that intrusive thoughts cause, they perform compulsions, which can happen externally (an action) or internally (an image or thought pattern).
Signs and symptoms of sensorimotor/somatic OCD
People can feel anxious about bodily functions, but if they don’t engage in compulsions for a sense of relief or safety, they’re probably not experiencing OCD. Here are some examples of what intrusive thoughts might sound like for someone with sensorimotor OCD:
- “What if I never stop noticing my swallowing?”
- “What if my breathing is not normal?”
- “I have to make myself blink, so I can ‘check’ that it’s normal.”
- “I can’t stop noticing every time I move my head.”
- “My tongue feels so weird in my mouth. Is it sitting in the right place?”
- “Does my eye contact look normal?”
- “Is my bladder working normally? I can always notice its pressure.”
- “I notice every tingle or itch on my body and worry that they happen too often.”
- “What if I forget how to chew?”
- “Is my heartbeat normal? I have to pay attention to it to check.”
- “What are my eyes doing when I’m talking to someone?”
- “What if I can never yawn?”
- “Will I keep noticing my breathing forever?”
Compulsions will vary as well, depending on each individual and which process or function their intrusive thoughts latch onto, but some examples include:
- Doing excessive research online to find similarities between your experience and others’, attempting to “get to the bottom” of whether your function is “normal” or find out how you can stop paying attention to the function.
- Seeking reassurance from yourself or others. You might repeat to yourself, “My breathing is totally normal, and I’m not paying attention to it,” or ask a loved one, “Do you think my breathing sounds normal?”
- Avoiding places or activities where your intrusive thoughts are especially triggered. For example, if your intrusive thoughts focus on chewing, you might avoid going out to dinner with friends because you won’t be able to be present.
- Mentally reviewing past experiences when you didn’t feel hyper aware and trying to figure out how you can get back to that state.
- You might try to distract yourself with books, movies, or other activities.
- You might induce the function (e.g., make yourself swallow) so that you can “check” its normalcy.
Sensorimotor or somatic OCD is sometimes confused with health anxiety. Health anxiety, also known as illness anxiety disorder, occurs when someone is hyperfocused on every sensation and occurrence in their bodies out of the fear that they have a serious illness. While they share similarities, the fear behind health anxiety is that you have an underlying medical condition. With sensorimotor or somatic OCD, the primary fear is that you won’t be able to stop paying attention to the function and/or that you’re not doing it “correctly.”
Finding treatment for sensory OCD
If you think you have OCD, whether it is related to your sensory processing or not, the best course of treatment is exposure and response prevention (ERP) therapy.
During ERP, your clinician will work with you to safely trigger your OCD symptoms. Once an obsession is triggered, you’ll experience a familiar rush of distress and anxiety. While you’d normally perform a compulsion to neutralize that obsession, ERP teaches you to sit with that distress and make a conscious choice not to engage in the cycle of OCD.
If sensory processing issues like sensory overload factor into your OCD, your therapist will prioritize working with you on developing sensory soothing strategies. Kilduff explains, “A neurodivergent person’s brain is wired such that sensory issues take priority to process and appropriately accommodate.” The tools and strategies used for people with sensory processing issues vary depending on the person. After these strategies are in place and you’re able to use them effectively, your therapist can focus on ERP therapy, since it requires a good deal of focus and brain processing.
Interoceptive exposures may also be used for people with panic disorders as well as OCD who experience interoception, or physiological, sensory issues. In these exposure exercises, sensory or physical experiences are actively triggered—perhaps you’ll work with your therapist to create bothersome noises, physical sensations, or visual stimuli. When you start to feel sensory overload creeping in, your therapist will guide you to accept these feelings and cope with them, rather than fighting them with compulsions. While it can feel overwhelming in the beginning, it will continue to get easier the more you practice.
Bottom line
Anyone can experience sensory processing issues, but it’s often more complex for people with OCD. It’s also more likely that you’ll experience sensory related challenges if you are already stressed, tired, or if you have an empty stomach, are thirsty, or feel rundown.
If you tend to have sensory processing problems, you should prioritize sleep, exercise to decrease stress, eat a nutritious, well-rounded diet, stay hydrated with water, and take breaks or seek alone time as necessary. These general wellbeing guidelines will help you approach the day from a more prepared place.
Also keep in mind that ERP is the best way to learn how to manage your OCD symptoms. Sensory issues paired with OCD can make things extremely difficult, but by understanding your struggles on a deeper level and working through them, you will be able to overcome the things that used to bring you the most discomfort, and learn how to cope in healthy ways.